Keneisha A Gustafson, PT in Roaring Spring, PA - Medicare Physical Therapist Provider

Keneisha A Gustafson, PT is a medicare enrolled "Physical Therapist" provider in Roaring Spring, Pennsylvania. Her current practice location is 7799 Woodbury Pike, Roaring Spring, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (814) 729-7021.

Keneisha A Gustafson is licensed to practice in Pennsylvania (license number PT032280) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750130175.

Contact Information

	Keneisha A Gustafson, PT
	7799 Woodbury Pike, Roaring Spring, PA 16673-1141
	(814) 729-7021
	(814) 948-7076

Map and Direction

Healthcare Provider's Profile

Full Name	Keneisha A Gustafson
Gender	Female
Speciality	Physical Therapist
Location	7799 Woodbury Pike, Roaring Spring, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750130175
Provider Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024

Medicare PECOS Information:

PECOS PAC ID: 5991244907
Enrollment ID: I20240822000200

Medical Identifiers

Medical identifiers for Keneisha A Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750130175	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT032280 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keneisha A Gustafson allows following entities to bill medicare on her behalf.

Provider Name	Mile-level Physical Therapy
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1801800651 PECOS PAC ID: 7315924016 Enrollment ID: O20040701000109

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keneisha A Gustafson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Keneisha A Gustafson, PT 1002 Philadelphia Ave, Northern Cambria, PA 15714-1339 Ph: (814) 948-7084	Keneisha A Gustafson, PT 7799 Woodbury Pike, Roaring Spring, PA 16673-1141 Ph: (814) 729-7021

Reviews and Comments

Physical Therapist in Roaring Spring, PA

Christina L Dively, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7448 Woodbury Pike, Roaring Spring, PA 16673 Phone: 812-224-5566 Fax: 814-224-2474
Philip A Herr, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 506 S Route 36, Roaring Spring, PA 16673 Phone: 814-224-1370 Fax: 814-224-1371
Dorothy Marie Witt, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 401 S Route 36, Roaring Spring, PA 16673 Phone: 814-224-5566 Fax: 814-224-2474
Kelly Lee Bushore, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 401 Rte 36 South, Roaring Spring, PA 16673 Phone: 814-224-5566
Joshua Greenberg, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 506 Marwalt Ln, Roaring Spring, PA 16673 Phone: 814-224-1370 Fax: 814-224-1371
Matthew Kevin Taylor, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 506 Marwalt Ln, Roaring Spring, PA 16673 Phone: 814-224-1370 Fax: 814-224-1371
Taylor Buchanan, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 7799 Woodbury Pike, Roaring Spring, PA 16673 Phone: 814-729-7021 Fax: 814-729-7068

Keneisha A Gustafson, PT - Medicare Physical Therapist in Roaring Spring, PA